State Medicaid programs want to keep telehealth expansions, KFF analysis finds

The Kaiser Family Foundation recently looked at state trends with regard to expanding access to telehealth-based behavioral care during the pandemic and found that states see telemedicine as a key component of maintaining access to behavioral healthcare for Medicaid enrollees.


KFF’s survey of state Medicaid programs found them not only expanding telehealth benefits – such as providing audio-only coverage of behavioral health services, group therapy and medication-assisted treatment – but also adding several provider types, researchers said in the issue brief.

They found that utilization declined from peak levels, but remains higher than before the pandemic. 

Some states experienced higher use of behavioral telehealth in rural areas, among younger enrollees or among white individuals. 

While most states report that they are likely to keep many of the pandemic-driven telehealth policy expansions in place, and all responding states took at least one policy action, says KFF.

Notably, by July 2022, all state Medicaid programs provided at least some audio-only coverage for behavioral wellness.

The researchers also found that Medicaid policies regarding allowable services, providers and originating sites varied widely and that “telehealth payment policies were unclear in many states.”

Some states reported “limiting or adding guardrails to pandemic-era behavioral health telehealth flexibilities,” the researchers added.


KFF noted that the 2022 Bipartisan Safer Communities Act legislation requires the federal government to issue telehealth guidance by the end of 2023 and the omnibus spending bill that Congress passed last month included several provisions affecting behavioral health telehealth.

While states differ in how they regulate synchronous and asynchronous telehealth, according to the American Telehealth Association, the organization is advocating for fair payment for telehealth as well as licensure flexibility across state lines.

“The ATA is committed to modality-neutral policies,” said Quinn Shean, strategic advisor at Tusk Ventures and the state policy advisor for ATA and ATA Action during a virtual discussion about telehealth policy after the pandemic. 

ATA applauded telehealth flexibilities in the recent bipartisan omnibus appropriations bill, thanking Congressional leaders specifically for including provisions delaying the Medicare telemental health in-person requirement for two years.

“Hard work continues, as we persist in pressing telehealth permanency and creating a lasting roadblock to the telehealth cliff,” said Kyle Zebley, ATA senior vice president for public policy at ATA Action and executive director in a statement about the legislation.


“Consistent with responses to KFF’s 2022 Medicaid budget survey, many states reported permanent (i.e. non-emergency) adoption of telehealth policy expansions that were initially enacted during the pandemic on a temporary basis,” said researchers in the briefing.

“In particular,” they said, “states frequently noted that all or most expansions of behavioral health providers and/or services allowed for telehealth would be maintained after the public health emergency.”

Andrea Fox is senior editor of Healthcare IT News.
Email: [email protected]

Healthcare IT News is a HIMSS publication.

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